Background:With advancements in burn treatment and intensive care leading to decreased mortality rates,a growing cohort of burn survivors is emerging.These individuals may be susceptible to frailty,characterized by re...Background:With advancements in burn treatment and intensive care leading to decreased mortality rates,a growing cohort of burn survivors is emerging.These individuals may be susceptible to frailty,characterized by reduced physiological reserve and increased vulnerability to stressors commonly associated with aging,which significantly complicates their recovery process.To date,no study has investigated burns as a potential risk factor for frailty.This study aimed to determine the short-term prevalence of frailty among burn survivors’months after injury and compare it with that of the general population.Methods:A post hoc analysis was conducted on the Randomized Trial of Enteral Glutamine to Minimize the Effects of Burn Injury(RE-ENERGIZE)trial,an international randomized-controlled trial involving 1200 burn injury patients with partial-or full-thickness burns.Participants who did not complete the 36-Item Short Form Health Survey(SF-36)questionnaire were excluded.Data for the general population were obtained from the 2022 National Health Interview Survey(NHIS).Frailty was assessed using the FRAIL(Fatigue,Resistance,Ambulation,Illness,Loss of weight)scale.Due to lack of data on loss of weight,for the purposes of this study,malnutrition was used as the fifth variable.Illness and malnutrition were based on admission data,while fatigue,resistance,and ambulation were determined from post-discharge responses to the SF-36.The burn cohort and general population groups were matched using propensity score matching and compared in terms of frailty status.Within the burn group,patients were divided into different subgroups based on their frailty status,and the differences in their(instrumental)activities of daily living(iADL and ADL)were compared.A multivariable analysis was performed within the burn cohort to identify factors predisposing to frailty as well as compromised iADL and ADL.Results:Out of the 1200 burn patients involved in the study,600 completed the required questionnaires[follow-up time:(5.5±2.3)months]and were matched to 1200 adults from the general population in the U.S.In comparison to the general population,burn patients exhibited a significantly higher likelihood of being pre-frail(42.3%vs.19.8%,P<0.0001),or frail(13.0%vs.1.0%,P<0.0001).When focusing on specific components,burn patients were more prone to experiencing fatigue(25.8%vs.13.5%,P<0.0001),limited resistance(34.0%vs.2.7%,P<0.0001),and restricted ambulation(41.8%vs.3.8%,P<0.0001).Conversely,the incidence rate of illness was observed to be higher in the general population(1.2%vs.2.8%,P=0.03),while no significant difference was detected regarding malnutrition(2.3%vs.2.6%,P=0.75).Furthermore,in comparison with robust burn patients,it was significantly more likely for pre-frail and frail patients to disclose compromise in ADL and iADL.The frail cohort reported the most pronounced limitation.Conclusions:Our findings suggest a higher incidence of post-discharge frailty among burn survivors in the short-term following injury.Burn survivors experience compromised fatigue,resistance,and ambulation,while rates of illness and malnutrition were lower or unchanged,respectively.These results underscore the critical need for early identification of frailty after a burn injury,with timely and comprehensive involvement of a multidisciplinary team including burn and pain specialists,community physicians,physiotherapists,nutritionists,and social workers.This collaborative effort can ensure holistic care to address and mitigate frailty in this patient population.展开更多
In this study, knowledge, attitude and perception (KAP) of maritime workers’ towards COVID-19 during the rapid outbreak in Nigeria and the UK were examined. The study participants completed a self-developed online KA...In this study, knowledge, attitude and perception (KAP) of maritime workers’ towards COVID-19 during the rapid outbreak in Nigeria and the UK were examined. The study participants completed a self-developed online KAP questionnaire prepared by the convenience sampling method. The knowledge questionnaire comprised questions regarding the clinical characteristics and prevention of COVID-19. The assessments regarding the maritime workers’ attitudes and perceptions towards COVID-19 included questions on preventive measures such as wearing masks on the ships and the attitude towards continuous trade with the Chinese communities. A multiple logistic regression analysis was done using SPSS Statistics version 23.0 to analyse the results of the two groups. The three explanatory variables, gender, residence and age used in the two models applied were not significant predictors of the participants’ knowledge, attitude and perception about COVID-19. The odds ratio was small, except for the age group, which was 6.72 in the first model. This implies that the odds of having knowledge about COVID-19 during the pandemic were 6.72 times higher for the older age group. The odds ratios were generally low for attitude and perception about COVID-19, as shown in Table 4. Participants had considerable knowledge about COVID-19 and could stay healthy during the first wave of the novel coronavirus in 2019 because of the policies and measures imposed by the governments of Nigeria and the United Kingdom to curtail the spread of COVID-19.展开更多
The physical and mental development of pupils could be arrested by inadequate food intake and infection with immediate and long term consequences. This has implications on decreased school performances, lower intellig...The physical and mental development of pupils could be arrested by inadequate food intake and infection with immediate and long term consequences. This has implications on decreased school performances, lower intelligent quotient levels, poor psychosocial development, and decreased cognitive functions. This study assessed the growth and body fat distribution among pupils aged 5 - 19 years. A cross-sectional study was conducted among pupils from five primary schools in different communities around Kainji Dam. This assessment was based on a comparison with reference standards set by the World Health Organization to determine their deviations. A qualified registered nurse carried out physical measurements to obtain age, height, and body weight using electronic weighing scale and stadiometer. Data were analyzed using Anthroplusv1.0.4 software. The overall prevalence of stunting was 21.5% with 8% being severely stunted. The prevalence of thinness was 35.2% with 11.2% being wasted while the overall prevalence of underweight was not calculated for children > 10 years old. The prevalence of underweight for 5 - 10 years old children was 16.9% with 2.4% being severely underweight. The curves for both male and female children deviated from normal distribution. Females have higher percentage of stunting than males. This study revealed a high prevalence of thinness and stunting which is the consequence of poor nutrition arising from multifaceted and interrelated circumstances such as poor feeding, eating practices and repeated infection. Intervention such as Home Grown School Feeding Programme of the Government is a right step in improving the nutritional status of pupils in rural communities.展开更多
Dengue fever,caused by the dengue virus(DENV),poses a significant public health challenge globally,with Nigeria experiencing sporadic outbreaks.A clear understanding of the dengue burden has not been achieved in Niger...Dengue fever,caused by the dengue virus(DENV),poses a significant public health challenge globally,with Nigeria experiencing sporadic outbreaks.A clear understanding of the dengue burden has not been achieved in Nigeria,just as in other African countries.Understanding the epidemiology and burden of dengue fever is essential for effective prevention and control strategies.This paper examines the recent dengue outbreaks in northern Nigeria,particularly in Sokoto state,and evaluates the recommended Takeda dengue vaccine(TDV)along with future prevention strategies.Despite limited surveillance and underreporting,dengue fever is endemic in Nigeria(with over 5 million cases and 5000 dengue-related deaths in 2023),with recent outbreaks indicating a growing concern.The TDV,a live attenuated tetravalent vaccine,has shown promise in preventing dengue fever,but challenges such as vaccine acceptance and access-ibility need to be addressed.Global urbanization contributes to the disease's spread,which is influenced by factors such as population density,cultural beliefs,water storage practices,hygiene,and water supply accessibility.Future prevention strategies must focus on government intervention,community practices,and innovative vector control measures to mitigate the spread of DENV in Nigeria.This study will serve as a valuable reference for policy-makers,researchers,and clinicians in the management and control of DENV in Nigeria and Africa as a whole.展开更多
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The obj...Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.展开更多
AIM: To quantitatively summarize and appraise the available evidence of urea breath test(UBT) use to diagnose Helicobacter pylori(H. pylori) infection in patients with dyspepsia and provide pooled diagnostic accuracy ...AIM: To quantitatively summarize and appraise the available evidence of urea breath test(UBT) use to diagnose Helicobacter pylori(H. pylori) infection in patients with dyspepsia and provide pooled diagnostic accuracy measures.METHODS: We searched MEDLINE, EMBASE, Cochrane library and other databases for studies addressing the value of UBT in the diagnosis of H. pylori infection. We included cross-sectional studies that evaluated the diagnostic accuracy of UBT in adult patients with dyspeptic symptoms. Risk of bias was assessed using QUADAS(Quality Assessment of Diagnostic Accuracy Studies)-2 tool. Diagnostic accuracy measures were pooled using the random-effects model. Subgroup analysis was conducted by UBT type(13C vs 14C) and by measurement technique(Infrared spectrometry vs Isotope Ratio Mass Spectrometry).RESULTS: Out of 1380 studies identified, only 23 met the eligibility criteria. Fourteen studies(61%) evaluated 13 C UBT and 9 studies(39%) evaluated 14 C UBT. There was significant variation in the type of reference standard tests used across studies.Pooled sensitivity was 0.96(95%CI: 0.95-0.97) andpooled specificity was 0.93(95%CI: 0.91-0.94). Likelihood ratio for a positive test was 12 and for a negative test was 0.05 with an area under thecurve of 0.985. Meta-analyses were associated with a significant statistical heterogeneity that remained unexplained after subgroup analysis. The included studies had a moderate risk of bias.CONCLUSION: UBT has high diagnostic accuracy for detecting H. pylori infection in patients with dyspepsia. The reliability of diagnostic meta-analytic estimates however is limited by significant heterogeneity.展开更多
Prevention of mother-to-child transmission(PMTCT)of HIV with highly active antiretroviral therapy(HARRT)allows the HIV^+pregnant mothers to have vaginal delivery and breastfeed.Here we investigated the maternal plasma...Prevention of mother-to-child transmission(PMTCT)of HIV with highly active antiretroviral therapy(HARRT)allows the HIV^+pregnant mothers to have vaginal delivery and breastfeed.Here we investigated the maternal plasma immunoglobulin,cytokine secretion and the outcome of the exposed infants among the HIV^+HAART treated pregnan women in Nigeria.In this study,different plasma immunoglobulins and cytokines were measured in the HIV^+HAART treated pregnant mothers.Pooled culture supernatants of B and T lymphocytes showed lower levels of IFN-γ,IL-10 and IL-4.There were lower IFN-γand IL-10 secretions at 1st trimester;however,IL-10 continued to be lower throughout 2nd and 3rd trimesters.TNF-αsecretion significantly decreased as pregnancy progressed to term.There were high plasma IgG and low IgM in the HIV^+HAART treated pregnant women.Plasma IgG was high during 1st and 3rd trimesters.After one year of follow up,all the exposed children were seronegative for HIV-1 and HIV-2.Vaginal delivery and breastfeeding among HIV^+HAART treated mothers have shown to be safe.The use of HAART by the infected mothers and the use of septrin and niverapin by the exposed infants prevented mother to-child transmission of HIV.展开更多
A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has s...A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has shown that other determinants can be very important in increasing(or reducing) incidence of this malignancy.The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground,and high risks of colorectal cancer have been reported among workers in some industrial branches.The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities,by means of a scientific literature review and meta-analysis.This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds,such as leather(RR = 1.70,95%CI:1.24-2.34),basic metals(RR = 1.32,95%CI:1.07-1.65),plastic and rubber manufacturing(RR = 1.30,95%CI:0.98-1.71 and RR = 1.27,95%CI:0.92-1.76,respectively),besides workers in the sector of repair and installation of machinery exposed to asbestos(RR = 1.40,95%CI:1.07-1.84).Based on our results,the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%.However,homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.展开更多
AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred...AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.展开更多
Hemichorea with corresponding putamenal T1 hyper-intensity and T2 hypointensity on MR imaging has occasionally been reported in diabetes mellitus with nonketotic hyperglycemia. However, the signal intensity in pu-tame...Hemichorea with corresponding putamenal T1 hyper-intensity and T2 hypointensity on MR imaging has occasionally been reported in diabetes mellitus with nonketotic hyperglycemia. However, the signal intensity in pu-tamenal and cerebellum lesion on MR imaging, which is believed to be pathogenetically related to hemichorea, is rarely documented in diabetes mellitus with nonketotic hyperglycemia. We describe a 57-year-old man with nonketotic hyperglycemic hemichorea on his right arm and legs, whose signal intensity in putamenal and cerebellum lesion was demonstrated by MR imaging.展开更多
Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are ma...Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are mainly responsible for vaginitis. The aim of this study is to determine the occurrence, clinical characteristics and associated risk factors of vulvovaginal candidiasis and bacterial vaginosis among women of reproductive age attending Primary Health Care centres in Lagos Nigeria. Methods:This cross-sectional study recruited 258 women with genital complaints after obtaining their informed written consent between May 2017 and March 2018. Structured questionnaires were administered and high vaginal swabs were collected for laboratory examination. The results were analysed with descriptive statistics, chi-square and simple logistic regression. Results: Out of the 210 (81.4%) of the women with one or more vaginal infections, 105 (50.0%), 26 (12.4%) had bacterial vaginosis, and vulvovaginal candidiasis respectively while 78 (37.1%) had both vulvovaginal candidiasis and bacterial vaginosis. Only 1 (0.5%) participant had trichomoniasis and bacterial vaginosis. History of abortion and age below 25 years were associated with vulvovaginal candidiasis while pregnancy, history of miscarriage, age at first sexual activity and discharge were associated with bacterial vaginosis. Itching was associated with both vulvovaginal candidiasis and bacterial vaginosis. Conclusion: This study revealed vulvovaginal candidiasis and bacterial vaginosis as important cause of genital complaints among reproductive age women in Lagos. Health education, robust diagnosis and early treatment are needed in order to reduce the associated risk factors, disease burden and complications.展开更多
The huge?congenital?intracranial teratoma is very rare. We report a case of a 77 years old male with giant congenital brain teratoma without clinical symptoms. His computed tomography (CT) scan showed a massive tumor ...The huge?congenital?intracranial teratoma is very rare. We report a case of a 77 years old male with giant congenital brain teratoma without clinical symptoms. His computed tomography (CT) scan showed a massive tumor (6 × 5 × 6 cm) of irregular high density (inside with some point flaky low density) in left temporal lobe region, the lower corner of the left ventricle downward shift, and enhanced CT scan no enhancement. Magnetic resonance imaging (MRI) on brain showed an irregular huge tumor in the left temporal lobe area, with multiple nodular or lobulated mixd high and low or equal signal changes, in which the liquid signal based. The midline was shift to the right, and the posterior horn of the left ventricle was compressed and downward shift, expansion, and hydrocephalus. After follow-up 12 months, the patient presents a normal daily life and work and no neurological signs as usual. Our observations show that the huge tumor in brain with multiple nodular or lobulated variety of mixed signal changes on MRI without symptoms is a congenital intracranial silent teratoma.展开更多
We report here the results of a prospective analysis of the pattern of antibiotics use over a one month period(May 2009)at two teaching hospitals in Sanandaj,western part of Iran.Data on antibiotic usage were obtained...We report here the results of a prospective analysis of the pattern of antibiotics use over a one month period(May 2009)at two teaching hospitals in Sanandaj,western part of Iran.Data on antibiotic usage were obtained from the pharmacy services.Data was coded,computed and analyzed using SPSS version 11.5.A total of 1336 and 556 patients from Beasat and Tohid hospital respectively received antibiotic.Male patients represented 758(41.5 %)and females 1080(58.5 %)of the total number of patients evaluated by physicians at the two hospitals during the one month period.Usage of antibiotics varied from hospital to hospital;Beasat hospital had the highest usage.The ward-wise distribution of antibiotic use showed that the prevalence of prescribing was highest in the post partum ward(66.58%).Similarly,among Tohid hospital wards,men surgical ward and women surgical ward prescribed antibiotics significantly more than all other wards.The route of administration of antibiotics was parentrally for 85.5% and 88.2% at Beasat anf Tohid hospitals respectively.The distribution of use of individual antibiotics showed that cepfzoline was the most frequently prescribed antibiotics used at both the hospitals.Delivery(childbirth)and pneumonia were the most frequent diagnosed pattern for which an antibiotic was prescribed at Beasat and Tohid hospital respectively.In conclusion our study suggests that there is considerable scope for improving prescribing pattern among the practitioners and minimizing the use of antibiotics.The improvement would be facilitated by providing feedback,prescriber education and hospital formulary.展开更多
Outcomes research, which investigates the outcomes of health care practices, is intended to provide scientific evidence for clinical decision making and health care. This paper elucidates the goal and domains of outco...Outcomes research, which investigates the outcomes of health care practices, is intended to provide scientific evidence for clinical decision making and health care. This paper elucidates the goal and domains of outcomes research. Also it shows the potential and promise of outcomes research to provide a methodology to uncover what to do and how to do it, and enable the health care profession to achieve the right care, for the right patient, at the right time, the first time, every time, nothing more, and nothing less.展开更多
Background: Although patients with acute headache frequently present in emergency department, the causes and predictors of short-term outcome in patients with acute headache in general neurology have not been adequate...Background: Although patients with acute headache frequently present in emergency department, the causes and predictors of short-term outcome in patients with acute headache in general neurology have not been adequately investigated. Methods: We prospectively reviewed the medical records of 130 hospitalized acute headache pa-tients in general neurology of China. Their initial CT scan was assessed, as was their lumbar puncture (LP) examination if performed. Results: The main cause of acute headache was acute secondary headache (80.8%), which was mainly attributable to acute cerebrovascular events (72.4%) followed by intracranial infection (19.0%). Among the 10.8% of patients who died during hospitalization most (85.7%) had subarachnoid hemorrhage (SAH). Significant predictors of survival were severe headache versus thunderclap headache, meningismus, de-layed loss of consciousness, and hypertension (all p < 0.05). Multiple logistic regression analyses showed significant differences in severe headache or thunderclap headache (OR, 0.255;95%CI, 0.066 - 0.990;p = 0.048) and delayed loss of consciousness (OR, 0.060;95%CI, 0.016 - 0.224, p = 0.000) between patients who died and those who survived. Conclusions: The main underlying cause of hospitalized acute headache was acute cerebrovascular events. Severe headache and delayed loss of consciousness are predictors for poor outcome of acute headache.展开更多
BACKGROUND Distal radius fractures(DRFs)are a common challenge in orthopaedic trauma care,yet for those fractures that are treated nonoperatively,strong evidence to guide cast treatment is still lacking.AIM To compare...BACKGROUND Distal radius fractures(DRFs)are a common challenge in orthopaedic trauma care,yet for those fractures that are treated nonoperatively,strong evidence to guide cast treatment is still lacking.AIM To compare the efficacy of below elbow cast(BEC)and above elbow cast(AEC)in maintaining reduction of manipulated DRFs.METHODS We conducted a prospective,monocentric,randomized,parallel-group,open label,blinded,noninferiority trial comparing the efficacy of BEC and AEC in the nonoperative treatment of DRFs.Two hundred and eighty patients>18 years of age diagnosed with DRFs were successfully randomized and included for analysis over a 3-year period.Noninferiority thresholds were defined as a 2 mm difference for radial length(RL),a 3°difference for radial inclination(RI),and volar tilt(VT).The trial is registered at Clinicaltrials.gov(NCT03468023).RESULTS One hundred and forty-three patients were treated with BEC,and 137 were treated with AEC.The mean time of immobilization was 33 d.The mean loss of RL,RI,and VT was 1.59 mm,2.83°,and 4.11°for BEC and 1.63 mm,2.54°,and VT loss were respectively 0.04 mm(95%CI:-0.36-0.44),-0.29°(95%CI:-1.03-0.45),and 0.59°(95%CI:-1.39-2.57),and they were all below the prefixed noninferiority thresholds.The rate of loss of reduction was similar.CONCLUSION BEC performs as well as AEC in maintaining the reduction of a manipulated DRF.Being more comfortable to patients,BEC may be preferable for nonoperative treatment of DRFs.展开更多
<strong>Background: </strong>Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case...<strong>Background: </strong>Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case management. This study determined the prevalence, etiology and antibiotic resistance profile of uropathogenic bacteria isolated from sexually active women with BV in Lagos Nigeria. <strong>Method:</strong> A total of 258 sexually active women presenting with gynaecological complaints at the maternal and child unit of twenty Primary Health Care Centres in Lagos Nigeria from May 2017 to March 2018 were consecutively enrolled with consent. Bacterial vaginosis was diagnosed based on Amsel criteria. Midstream urine samples were collected aseptically, analyzed for bacterial pathogens and antibiotic susceptibility using standard microbiological methods. <strong>Results:</strong> BV was diagnosed in 184 (71.3%) with 69.2% also having UTI. Ninety four (36.4%) had UTI predominantly caused by Gram negative bacteria (96.8%). The organisms isolated were <em>Escherichia coli</em> 79 (84.0%), <em>Klebsiella pneumoniae</em> 5 (5.3%), <em>Pseudomonas aeruginosa</em> 4 (4.3%), <em>Proteus mirabilis</em> 3 (3.2%) and <em>Staphylococcus saprophyticus</em> 3 (3.2%). The pathogens elicited high resistance (66.7% - 100%) to tetracycline, amoxicillin-clavulanic acid, nitrofurantoin and cephalosporins, and moderate resistance (50%) to ofloxacin by <em>P. aeruginosa</em> strains. The isolates were susceptible (100%) to piperacillin-tazobactam and meropenem. Multi-drug resistance (MDR) was observed among 97.8% of the bacteria isolated. <strong>Conclusion: </strong>Findings from this study indicate high occurrence of UTI caused by MDR pathogens among sexually active women with BV with emerging evidence of poor clinical utility of nitrofurantoin and other commonly used first-line antibiotics against UTI. Further studies on non-bacterial aetiology of BV, molecular characterization of <em>S. saprophyticus</em> and Gram Negative Bacteria UTI are recommended.展开更多
<span style="font-size:10.0pt;font-family:;" "=""><strong>Background:</strong></span><span style="font-size:10.0pt;font-family:;" "=""> T...<span style="font-size:10.0pt;font-family:;" "=""><strong>Background:</strong></span><span style="font-size:10.0pt;font-family:;" "=""> The prevalence of obesity is increasing dramatically around the <span>world and it is reasonable to assume that young people attending school in</span> <span>Brazzaville are not spared. The objective of this study was to determine the pre</span>valence, as well as the factors associated with obesity and overweight among <span>students in Brazzaville. <b>Methods:</b> This is a cross-sectional study, conducted</span> as a questionnaire survey with 2052 pupils (869 boys and 1183 girls, aged 14 to 18). Obesity and overweight were determined from the body mass index and <span>reference curves of the International Obesity Task Force (IOTF), the associated factors, by performing </span></span><span style="font-size:10.0pt;font-family:;" "="">the</span><span style="font-size:10.0pt;font-family:;" "=""> logistic regression. <b>Results:</b> The preva</span><span style="font-size:10.0pt;font-family:;" "="">lence of over<span>weight in private and public institutions was 15.6% versus 5.5% (p < 0.001) </span><span>and obesity prevalence was 4.0% versus 1.5% (p < 0.001), respectively. The main factors associated with obesity and overweight were: parents’</span> monthly income (OR = 1.73), car as a means of transportation (OR = 2.75) and family history <span>of obesity (OR = 7.73). On the other hand, attending a public school,</span></span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:10.0pt;font-family:;" "="">walk</span><span style="font-size:10.0pt;font-family:;" "="">ing and high levels of physical activity had a protective effect against obesity in this population. <b>Conclusion: </b>The prevalence of obesity was higher in private institutions and require</span><span style="font-size:10.0pt;font-family:;" "="">d</span><span style="font-size:10.0pt;font-family:;" "=""> management and prevention strategies.</span>展开更多
基金supported by the U.S.Department of Defense(W81XWH-09-2-0194 for the pilot phase)the Canadian Institutes of Health Research(MCT-94834 for the pilot phase and 14238 for the definitive phase).
文摘Background:With advancements in burn treatment and intensive care leading to decreased mortality rates,a growing cohort of burn survivors is emerging.These individuals may be susceptible to frailty,characterized by reduced physiological reserve and increased vulnerability to stressors commonly associated with aging,which significantly complicates their recovery process.To date,no study has investigated burns as a potential risk factor for frailty.This study aimed to determine the short-term prevalence of frailty among burn survivors’months after injury and compare it with that of the general population.Methods:A post hoc analysis was conducted on the Randomized Trial of Enteral Glutamine to Minimize the Effects of Burn Injury(RE-ENERGIZE)trial,an international randomized-controlled trial involving 1200 burn injury patients with partial-or full-thickness burns.Participants who did not complete the 36-Item Short Form Health Survey(SF-36)questionnaire were excluded.Data for the general population were obtained from the 2022 National Health Interview Survey(NHIS).Frailty was assessed using the FRAIL(Fatigue,Resistance,Ambulation,Illness,Loss of weight)scale.Due to lack of data on loss of weight,for the purposes of this study,malnutrition was used as the fifth variable.Illness and malnutrition were based on admission data,while fatigue,resistance,and ambulation were determined from post-discharge responses to the SF-36.The burn cohort and general population groups were matched using propensity score matching and compared in terms of frailty status.Within the burn group,patients were divided into different subgroups based on their frailty status,and the differences in their(instrumental)activities of daily living(iADL and ADL)were compared.A multivariable analysis was performed within the burn cohort to identify factors predisposing to frailty as well as compromised iADL and ADL.Results:Out of the 1200 burn patients involved in the study,600 completed the required questionnaires[follow-up time:(5.5±2.3)months]and were matched to 1200 adults from the general population in the U.S.In comparison to the general population,burn patients exhibited a significantly higher likelihood of being pre-frail(42.3%vs.19.8%,P<0.0001),or frail(13.0%vs.1.0%,P<0.0001).When focusing on specific components,burn patients were more prone to experiencing fatigue(25.8%vs.13.5%,P<0.0001),limited resistance(34.0%vs.2.7%,P<0.0001),and restricted ambulation(41.8%vs.3.8%,P<0.0001).Conversely,the incidence rate of illness was observed to be higher in the general population(1.2%vs.2.8%,P=0.03),while no significant difference was detected regarding malnutrition(2.3%vs.2.6%,P=0.75).Furthermore,in comparison with robust burn patients,it was significantly more likely for pre-frail and frail patients to disclose compromise in ADL and iADL.The frail cohort reported the most pronounced limitation.Conclusions:Our findings suggest a higher incidence of post-discharge frailty among burn survivors in the short-term following injury.Burn survivors experience compromised fatigue,resistance,and ambulation,while rates of illness and malnutrition were lower or unchanged,respectively.These results underscore the critical need for early identification of frailty after a burn injury,with timely and comprehensive involvement of a multidisciplinary team including burn and pain specialists,community physicians,physiotherapists,nutritionists,and social workers.This collaborative effort can ensure holistic care to address and mitigate frailty in this patient population.
文摘In this study, knowledge, attitude and perception (KAP) of maritime workers’ towards COVID-19 during the rapid outbreak in Nigeria and the UK were examined. The study participants completed a self-developed online KAP questionnaire prepared by the convenience sampling method. The knowledge questionnaire comprised questions regarding the clinical characteristics and prevention of COVID-19. The assessments regarding the maritime workers’ attitudes and perceptions towards COVID-19 included questions on preventive measures such as wearing masks on the ships and the attitude towards continuous trade with the Chinese communities. A multiple logistic regression analysis was done using SPSS Statistics version 23.0 to analyse the results of the two groups. The three explanatory variables, gender, residence and age used in the two models applied were not significant predictors of the participants’ knowledge, attitude and perception about COVID-19. The odds ratio was small, except for the age group, which was 6.72 in the first model. This implies that the odds of having knowledge about COVID-19 during the pandemic were 6.72 times higher for the older age group. The odds ratios were generally low for attitude and perception about COVID-19, as shown in Table 4. Participants had considerable knowledge about COVID-19 and could stay healthy during the first wave of the novel coronavirus in 2019 because of the policies and measures imposed by the governments of Nigeria and the United Kingdom to curtail the spread of COVID-19.
文摘The physical and mental development of pupils could be arrested by inadequate food intake and infection with immediate and long term consequences. This has implications on decreased school performances, lower intelligent quotient levels, poor psychosocial development, and decreased cognitive functions. This study assessed the growth and body fat distribution among pupils aged 5 - 19 years. A cross-sectional study was conducted among pupils from five primary schools in different communities around Kainji Dam. This assessment was based on a comparison with reference standards set by the World Health Organization to determine their deviations. A qualified registered nurse carried out physical measurements to obtain age, height, and body weight using electronic weighing scale and stadiometer. Data were analyzed using Anthroplusv1.0.4 software. The overall prevalence of stunting was 21.5% with 8% being severely stunted. The prevalence of thinness was 35.2% with 11.2% being wasted while the overall prevalence of underweight was not calculated for children > 10 years old. The prevalence of underweight for 5 - 10 years old children was 16.9% with 2.4% being severely underweight. The curves for both male and female children deviated from normal distribution. Females have higher percentage of stunting than males. This study revealed a high prevalence of thinness and stunting which is the consequence of poor nutrition arising from multifaceted and interrelated circumstances such as poor feeding, eating practices and repeated infection. Intervention such as Home Grown School Feeding Programme of the Government is a right step in improving the nutritional status of pupils in rural communities.
文摘Dengue fever,caused by the dengue virus(DENV),poses a significant public health challenge globally,with Nigeria experiencing sporadic outbreaks.A clear understanding of the dengue burden has not been achieved in Nigeria,just as in other African countries.Understanding the epidemiology and burden of dengue fever is essential for effective prevention and control strategies.This paper examines the recent dengue outbreaks in northern Nigeria,particularly in Sokoto state,and evaluates the recommended Takeda dengue vaccine(TDV)along with future prevention strategies.Despite limited surveillance and underreporting,dengue fever is endemic in Nigeria(with over 5 million cases and 5000 dengue-related deaths in 2023),with recent outbreaks indicating a growing concern.The TDV,a live attenuated tetravalent vaccine,has shown promise in preventing dengue fever,but challenges such as vaccine acceptance and access-ibility need to be addressed.Global urbanization contributes to the disease's spread,which is influenced by factors such as population density,cultural beliefs,water storage practices,hygiene,and water supply accessibility.Future prevention strategies must focus on government intervention,community practices,and innovative vector control measures to mitigate the spread of DENV in Nigeria.This study will serve as a valuable reference for policy-makers,researchers,and clinicians in the management and control of DENV in Nigeria and Africa as a whole.
文摘Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.
文摘AIM: To quantitatively summarize and appraise the available evidence of urea breath test(UBT) use to diagnose Helicobacter pylori(H. pylori) infection in patients with dyspepsia and provide pooled diagnostic accuracy measures.METHODS: We searched MEDLINE, EMBASE, Cochrane library and other databases for studies addressing the value of UBT in the diagnosis of H. pylori infection. We included cross-sectional studies that evaluated the diagnostic accuracy of UBT in adult patients with dyspeptic symptoms. Risk of bias was assessed using QUADAS(Quality Assessment of Diagnostic Accuracy Studies)-2 tool. Diagnostic accuracy measures were pooled using the random-effects model. Subgroup analysis was conducted by UBT type(13C vs 14C) and by measurement technique(Infrared spectrometry vs Isotope Ratio Mass Spectrometry).RESULTS: Out of 1380 studies identified, only 23 met the eligibility criteria. Fourteen studies(61%) evaluated 13 C UBT and 9 studies(39%) evaluated 14 C UBT. There was significant variation in the type of reference standard tests used across studies.Pooled sensitivity was 0.96(95%CI: 0.95-0.97) andpooled specificity was 0.93(95%CI: 0.91-0.94). Likelihood ratio for a positive test was 12 and for a negative test was 0.05 with an area under thecurve of 0.985. Meta-analyses were associated with a significant statistical heterogeneity that remained unexplained after subgroup analysis. The included studies had a moderate risk of bias.CONCLUSION: UBT has high diagnostic accuracy for detecting H. pylori infection in patients with dyspepsia. The reliability of diagnostic meta-analytic estimates however is limited by significant heterogeneity.
文摘Prevention of mother-to-child transmission(PMTCT)of HIV with highly active antiretroviral therapy(HARRT)allows the HIV^+pregnant mothers to have vaginal delivery and breastfeed.Here we investigated the maternal plasma immunoglobulin,cytokine secretion and the outcome of the exposed infants among the HIV^+HAART treated pregnan women in Nigeria.In this study,different plasma immunoglobulins and cytokines were measured in the HIV^+HAART treated pregnant mothers.Pooled culture supernatants of B and T lymphocytes showed lower levels of IFN-γ,IL-10 and IL-4.There were lower IFN-γand IL-10 secretions at 1st trimester;however,IL-10 continued to be lower throughout 2nd and 3rd trimesters.TNF-αsecretion significantly decreased as pregnancy progressed to term.There were high plasma IgG and low IgM in the HIV^+HAART treated pregnant women.Plasma IgG was high during 1st and 3rd trimesters.After one year of follow up,all the exposed children were seronegative for HIV-1 and HIV-2.Vaginal delivery and breastfeeding among HIV^+HAART treated mothers have shown to be safe.The use of HAART by the infected mothers and the use of septrin and niverapin by the exposed infants prevented mother to-child transmission of HIV.
文摘A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has shown that other determinants can be very important in increasing(or reducing) incidence of this malignancy.The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground,and high risks of colorectal cancer have been reported among workers in some industrial branches.The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities,by means of a scientific literature review and meta-analysis.This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds,such as leather(RR = 1.70,95%CI:1.24-2.34),basic metals(RR = 1.32,95%CI:1.07-1.65),plastic and rubber manufacturing(RR = 1.30,95%CI:0.98-1.71 and RR = 1.27,95%CI:0.92-1.76,respectively),besides workers in the sector of repair and installation of machinery exposed to asbestos(RR = 1.40,95%CI:1.07-1.84).Based on our results,the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%.However,homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.
文摘AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.
文摘Hemichorea with corresponding putamenal T1 hyper-intensity and T2 hypointensity on MR imaging has occasionally been reported in diabetes mellitus with nonketotic hyperglycemia. However, the signal intensity in pu-tamenal and cerebellum lesion on MR imaging, which is believed to be pathogenetically related to hemichorea, is rarely documented in diabetes mellitus with nonketotic hyperglycemia. We describe a 57-year-old man with nonketotic hyperglycemic hemichorea on his right arm and legs, whose signal intensity in putamenal and cerebellum lesion was demonstrated by MR imaging.
文摘Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are mainly responsible for vaginitis. The aim of this study is to determine the occurrence, clinical characteristics and associated risk factors of vulvovaginal candidiasis and bacterial vaginosis among women of reproductive age attending Primary Health Care centres in Lagos Nigeria. Methods:This cross-sectional study recruited 258 women with genital complaints after obtaining their informed written consent between May 2017 and March 2018. Structured questionnaires were administered and high vaginal swabs were collected for laboratory examination. The results were analysed with descriptive statistics, chi-square and simple logistic regression. Results: Out of the 210 (81.4%) of the women with one or more vaginal infections, 105 (50.0%), 26 (12.4%) had bacterial vaginosis, and vulvovaginal candidiasis respectively while 78 (37.1%) had both vulvovaginal candidiasis and bacterial vaginosis. Only 1 (0.5%) participant had trichomoniasis and bacterial vaginosis. History of abortion and age below 25 years were associated with vulvovaginal candidiasis while pregnancy, history of miscarriage, age at first sexual activity and discharge were associated with bacterial vaginosis. Itching was associated with both vulvovaginal candidiasis and bacterial vaginosis. Conclusion: This study revealed vulvovaginal candidiasis and bacterial vaginosis as important cause of genital complaints among reproductive age women in Lagos. Health education, robust diagnosis and early treatment are needed in order to reduce the associated risk factors, disease burden and complications.
文摘The huge?congenital?intracranial teratoma is very rare. We report a case of a 77 years old male with giant congenital brain teratoma without clinical symptoms. His computed tomography (CT) scan showed a massive tumor (6 × 5 × 6 cm) of irregular high density (inside with some point flaky low density) in left temporal lobe region, the lower corner of the left ventricle downward shift, and enhanced CT scan no enhancement. Magnetic resonance imaging (MRI) on brain showed an irregular huge tumor in the left temporal lobe area, with multiple nodular or lobulated mixd high and low or equal signal changes, in which the liquid signal based. The midline was shift to the right, and the posterior horn of the left ventricle was compressed and downward shift, expansion, and hydrocephalus. After follow-up 12 months, the patient presents a normal daily life and work and no neurological signs as usual. Our observations show that the huge tumor in brain with multiple nodular or lobulated variety of mixed signal changes on MRI without symptoms is a congenital intracranial silent teratoma.
文摘We report here the results of a prospective analysis of the pattern of antibiotics use over a one month period(May 2009)at two teaching hospitals in Sanandaj,western part of Iran.Data on antibiotic usage were obtained from the pharmacy services.Data was coded,computed and analyzed using SPSS version 11.5.A total of 1336 and 556 patients from Beasat and Tohid hospital respectively received antibiotic.Male patients represented 758(41.5 %)and females 1080(58.5 %)of the total number of patients evaluated by physicians at the two hospitals during the one month period.Usage of antibiotics varied from hospital to hospital;Beasat hospital had the highest usage.The ward-wise distribution of antibiotic use showed that the prevalence of prescribing was highest in the post partum ward(66.58%).Similarly,among Tohid hospital wards,men surgical ward and women surgical ward prescribed antibiotics significantly more than all other wards.The route of administration of antibiotics was parentrally for 85.5% and 88.2% at Beasat anf Tohid hospitals respectively.The distribution of use of individual antibiotics showed that cepfzoline was the most frequently prescribed antibiotics used at both the hospitals.Delivery(childbirth)and pneumonia were the most frequent diagnosed pattern for which an antibiotic was prescribed at Beasat and Tohid hospital respectively.In conclusion our study suggests that there is considerable scope for improving prescribing pattern among the practitioners and minimizing the use of antibiotics.The improvement would be facilitated by providing feedback,prescriber education and hospital formulary.
文摘Outcomes research, which investigates the outcomes of health care practices, is intended to provide scientific evidence for clinical decision making and health care. This paper elucidates the goal and domains of outcomes research. Also it shows the potential and promise of outcomes research to provide a methodology to uncover what to do and how to do it, and enable the health care profession to achieve the right care, for the right patient, at the right time, the first time, every time, nothing more, and nothing less.
文摘Background: Although patients with acute headache frequently present in emergency department, the causes and predictors of short-term outcome in patients with acute headache in general neurology have not been adequately investigated. Methods: We prospectively reviewed the medical records of 130 hospitalized acute headache pa-tients in general neurology of China. Their initial CT scan was assessed, as was their lumbar puncture (LP) examination if performed. Results: The main cause of acute headache was acute secondary headache (80.8%), which was mainly attributable to acute cerebrovascular events (72.4%) followed by intracranial infection (19.0%). Among the 10.8% of patients who died during hospitalization most (85.7%) had subarachnoid hemorrhage (SAH). Significant predictors of survival were severe headache versus thunderclap headache, meningismus, de-layed loss of consciousness, and hypertension (all p < 0.05). Multiple logistic regression analyses showed significant differences in severe headache or thunderclap headache (OR, 0.255;95%CI, 0.066 - 0.990;p = 0.048) and delayed loss of consciousness (OR, 0.060;95%CI, 0.016 - 0.224, p = 0.000) between patients who died and those who survived. Conclusions: The main underlying cause of hospitalized acute headache was acute cerebrovascular events. Severe headache and delayed loss of consciousness are predictors for poor outcome of acute headache.
文摘BACKGROUND Distal radius fractures(DRFs)are a common challenge in orthopaedic trauma care,yet for those fractures that are treated nonoperatively,strong evidence to guide cast treatment is still lacking.AIM To compare the efficacy of below elbow cast(BEC)and above elbow cast(AEC)in maintaining reduction of manipulated DRFs.METHODS We conducted a prospective,monocentric,randomized,parallel-group,open label,blinded,noninferiority trial comparing the efficacy of BEC and AEC in the nonoperative treatment of DRFs.Two hundred and eighty patients>18 years of age diagnosed with DRFs were successfully randomized and included for analysis over a 3-year period.Noninferiority thresholds were defined as a 2 mm difference for radial length(RL),a 3°difference for radial inclination(RI),and volar tilt(VT).The trial is registered at Clinicaltrials.gov(NCT03468023).RESULTS One hundred and forty-three patients were treated with BEC,and 137 were treated with AEC.The mean time of immobilization was 33 d.The mean loss of RL,RI,and VT was 1.59 mm,2.83°,and 4.11°for BEC and 1.63 mm,2.54°,and VT loss were respectively 0.04 mm(95%CI:-0.36-0.44),-0.29°(95%CI:-1.03-0.45),and 0.59°(95%CI:-1.39-2.57),and they were all below the prefixed noninferiority thresholds.The rate of loss of reduction was similar.CONCLUSION BEC performs as well as AEC in maintaining the reduction of a manipulated DRF.Being more comfortable to patients,BEC may be preferable for nonoperative treatment of DRFs.
文摘<strong>Background: </strong>Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case management. This study determined the prevalence, etiology and antibiotic resistance profile of uropathogenic bacteria isolated from sexually active women with BV in Lagos Nigeria. <strong>Method:</strong> A total of 258 sexually active women presenting with gynaecological complaints at the maternal and child unit of twenty Primary Health Care Centres in Lagos Nigeria from May 2017 to March 2018 were consecutively enrolled with consent. Bacterial vaginosis was diagnosed based on Amsel criteria. Midstream urine samples were collected aseptically, analyzed for bacterial pathogens and antibiotic susceptibility using standard microbiological methods. <strong>Results:</strong> BV was diagnosed in 184 (71.3%) with 69.2% also having UTI. Ninety four (36.4%) had UTI predominantly caused by Gram negative bacteria (96.8%). The organisms isolated were <em>Escherichia coli</em> 79 (84.0%), <em>Klebsiella pneumoniae</em> 5 (5.3%), <em>Pseudomonas aeruginosa</em> 4 (4.3%), <em>Proteus mirabilis</em> 3 (3.2%) and <em>Staphylococcus saprophyticus</em> 3 (3.2%). The pathogens elicited high resistance (66.7% - 100%) to tetracycline, amoxicillin-clavulanic acid, nitrofurantoin and cephalosporins, and moderate resistance (50%) to ofloxacin by <em>P. aeruginosa</em> strains. The isolates were susceptible (100%) to piperacillin-tazobactam and meropenem. Multi-drug resistance (MDR) was observed among 97.8% of the bacteria isolated. <strong>Conclusion: </strong>Findings from this study indicate high occurrence of UTI caused by MDR pathogens among sexually active women with BV with emerging evidence of poor clinical utility of nitrofurantoin and other commonly used first-line antibiotics against UTI. Further studies on non-bacterial aetiology of BV, molecular characterization of <em>S. saprophyticus</em> and Gram Negative Bacteria UTI are recommended.
文摘<span style="font-size:10.0pt;font-family:;" "=""><strong>Background:</strong></span><span style="font-size:10.0pt;font-family:;" "=""> The prevalence of obesity is increasing dramatically around the <span>world and it is reasonable to assume that young people attending school in</span> <span>Brazzaville are not spared. The objective of this study was to determine the pre</span>valence, as well as the factors associated with obesity and overweight among <span>students in Brazzaville. <b>Methods:</b> This is a cross-sectional study, conducted</span> as a questionnaire survey with 2052 pupils (869 boys and 1183 girls, aged 14 to 18). Obesity and overweight were determined from the body mass index and <span>reference curves of the International Obesity Task Force (IOTF), the associated factors, by performing </span></span><span style="font-size:10.0pt;font-family:;" "="">the</span><span style="font-size:10.0pt;font-family:;" "=""> logistic regression. <b>Results:</b> The preva</span><span style="font-size:10.0pt;font-family:;" "="">lence of over<span>weight in private and public institutions was 15.6% versus 5.5% (p < 0.001) </span><span>and obesity prevalence was 4.0% versus 1.5% (p < 0.001), respectively. The main factors associated with obesity and overweight were: parents’</span> monthly income (OR = 1.73), car as a means of transportation (OR = 2.75) and family history <span>of obesity (OR = 7.73). On the other hand, attending a public school,</span></span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:10.0pt;font-family:;" "="">walk</span><span style="font-size:10.0pt;font-family:;" "="">ing and high levels of physical activity had a protective effect against obesity in this population. <b>Conclusion: </b>The prevalence of obesity was higher in private institutions and require</span><span style="font-size:10.0pt;font-family:;" "="">d</span><span style="font-size:10.0pt;font-family:;" "=""> management and prevention strategies.</span>
